University of Twente Student Theses
Intracranial pressure pulse morphology and intracranial compliance analysis during liquor drainage in patients with traumatic brain injury
Leeuw, A.S.D. de (2024) Intracranial pressure pulse morphology and intracranial compliance analysis during liquor drainage in patients with traumatic brain injury.
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| Abstract: | Introduction: Traumatic brain injury (TBI) patients often face increased intracranial pressure (ICP), leading to intracranial hypertension (IH) and decreased intracranial compliance (ICC). The RAP-index, correlating ICP pulse amplitude with mean ICP, is the current gold standard for ICC assessment. This study evaluates ICP pulse morphology analyses to determine their clinical utility in assessing ICC during consecutive cerebrospinal fluid (CSF) drainage events in TBI patients, comparing their effectiveness with the RAP-index. Methods: ICP pulse morphology was analyzed in the time and frequency domain before and after CSF drainage in nine TBI patients. A viscoelastic model was also investigated by optimizing state$-$space parameters. Data were visualized over time and per drainage event, relative to ICP changes. Results: Analysis of 534 drainage events identified ten metrics distinguishing ICC and predicting TBI mortality. The second-to-first (dP2/dP1), third-to-second (dP3/dP2) peak ratio and curvature of the first peak (Curv1), showed immediate changes after drainage, outperforming the RAP-index. The viscoelastic model successfully scaled arterial blood pressure (ABP) pulses to ICP pulses. Conclusion: Improved ICP pulse morphology analyses, particularly dP2/dP1, dP3/dP2, and Curv1, could enhance ICC assessment and mortality prediction, supporting bedside monitoring for TBI patients. |
| Item Type: | Essay (Master) |
| Clients: | Radboud University Medical Centre, Nijmegen, Netherlands |
| Faculty: | TNW: Science and Technology |
| Subject: | 44 medicine, 50 technical science in general |
| Programme: | Technical Medicine MSc (60033) |
| Link to this item: | https://purl.utwente.nl/essays/104728 |
| Export this item as: | BibTeX EndNote HTML Citation Reference Manager |
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